How To Get Abortion After Supreme Court Overturned Roe

If abortion is illegal or inaccessible where you live, you generally have two options: travel to a state where the procedure is protected or self-manage an abortion using medication at home.

People have been safely accessing care both ways for years. In the wake of Texas’s six-week ban taking effect in September 2021, thousands of Texans have obtained abortions out of state, according to the University of Texas at Austin’s Texas Policy Evaluation Project. And in 2020, medication abortions accounted for more than half of all abortions in the US, according to the Guttmacher Institute.

“It’s just going to be a broader application of what we already see happening to many people,” Diaz-Tello said.

If you need help covering the costs associated with traveling out of state for care, your local abortion fund can provide financial support for childcare, airfare, lodging, gas, and other expenses, said Emma Hernández, a spokesperson for the reproductive justice nonprofit We Testify.

“They can also drive you to your appointment itself, pick you up from an airport, provide you perhaps a place to stay depending on the need that you have and what’s locally available,” Hernández said.

Is it safe to travel across state lines for an abortion?

Yes. People have traveled across state lines — and across the country — to get abortions for decades. There has been talk among anti-abortion legislators of trying to prevent people from leaving their states for care or punish them when they return, but there are currently no laws on the books that would allow them to do so.

“We’ll have to see which states pass those kinds of laws and how they actually go into effect — they’re certainly going to get challenged,” said Aziza Ahmed, a law professor at the University of California, Irvine.

Generally, if someone commits a crime in one state but goes to another, there is an expectation that the second state would hand that person over to the jurisdiction where the crime was committed, Ahmed said. But whether a state could prosecute someone for committing what it considers to be a crime in another jurisdiction where the same act is legal is unclear.

“We’re not sure how this is going to play out,” Ahmed said.

Anti-abortion lawmakers, though, will certainly try to prosecute people who travel for abortion care, even if it’s unclear if they have the legal authority to do so, she added.

“The states have already proven themselves to be extremely cruel and indifferent to people’s lives,” Ahmed said. “I think they’re going to try to prosecute people and then they’re going to wait for the challenge and … destroy people’s lives while they’re doing it to scare everyone.”

Meanwhile, states where abortion remains legal have been working to shore up protections and provide more assistance for people who travel there for care. In May, Connecticut Gov. Ned Lamont signed a bill into law that prohibits state officials and health providers from cooperating with lawsuits waged against patients who travel to Connecticut for the procedure. Other states, like California and New York, are considering similar legislation along with other measures.

What is medication abortion and how can I get the pills?

Medication abortion is a nonsurgical procedure that involves taking a combination of prescription medications called mifepristone and misoprostol to end a pregnancy of up to 11 weeks. Mifepristone blocks progesterone, the hormone needed for a pregnancy to continue, and then misoprostol causes the uterus to expel its contents.

The method has been widely tested, has a high success rate, and has resulted in very few incidents of hospitalization. The medications are approved by the FDA, which allows healthcare providers to administer the pills in person or send them to patients by mail, but several states have adopted laws restricting how the medications are dispensed (more on that later).

Plan C provides state-by-state information on how to access medication abortion — and the potential legal risks you may face — where you live. Organizations like Abortion on Demand, Aid Access, and Hey Jane provide the pills by mail. The Miscarriage and Abortion Hotline helps people navigate how to use the medications on their own. If/When/How’s Repro Legal Helpline, which can be reached by phone at 844-868-2812 or online via reprolegalhelpline.org, is also a resource for people seeking secure and confidential legal guidance on how to self-manage an abortion.

“If folks aren’t able to travel, which is the majority of people living in these states, this is going to be a really important point of access for them,” Shah said.

Is it legal to use medication abortion?

The answer to this question is a bit more complicated, Diaz-Tello said. While only three states — Oklahoma, South Carolina, and Nevada — currently have laws criminalizing self-managed abortion, many more have adopted laws restricting access to medication abortion. According to the Guttmacher Institute, 19 states prohibit the use of telemedicine to prescribe medication abortion, and 32 states require clinicians who administer the pills to be physicians, rather than nurse practitioners or other licensed medical professionals.

And while anti-abortion lawmakers and advocates claim restrictions on abortion are not intended to criminalize the pregnant person, people have been prosecuted for ending their own pregnancies. In April, a 26-year-old Texas woman was arrested and charged with murder for being involved in a “self-induced abortion.” She was later released and prosecutors acknowledged she did not violate any laws.

“It is possible that you could be violating the law by using medication abortion if there’s a law that says they will actually prosecute pregnant women or if it’s gray enough,” Ahmed said. “As we all saw in Texas, they already tried to do that.”

But given that medication abortion is FDA-approved, experts said it’s still unclear whether states’ restrictions on access are even legal.

“Unfortunately, I think it’s one of those things where we can’t really know the answer until there is a legal challenge,” Diaz-Tello said.

How can I protect myself against prosecution?

One important thing to know is that healthcare providers wouldn’t be able to tell if you’re having a miscarriage or a medication-induced abortion when taking the pills orally, so experts said it’s not necessary to share that information with hospital staff in the event you needed to seek medical attention.

“There’s no difference between a prompted miscarriage and one that occurs spontaneously, and there’s no difference in the care that they would seek,” Diaz-Tello said. “The pills themselves are not clinically relevant.”

However, when taken intravaginally, the pills can leave residue, said Dr. Ghazaleh Moayedi, an obstetrics and gynecologist who provides abortion care in Texas. Moayedi said it feels wrong to tell people to only use medication abortion orally, noting that taking it intravaginally can reduce some of the side effects of the drugs, like diarrhea, and can be good for people with certain medical conditions. Still, she agreed that people who are accessing pills “in a clandestine fashion” should take them orally for that reason.

“I don’t want to live in a country where we have to tell patients to lie to their healthcare providers to be safe,” Moayedi said. “But also people are telling on you. … We need to be careful.”

To protect yourself from criminalization, you should also just generally be cautious about whom you share personal health information with, Diaz-Tello said.

The Repro Legal Helpline also recommends using a VPN to hide your internet search activity and encrypted messaging services like Signal to protect your private conversations. When people are prosecuted for self-managing an abortion, law enforcement can gain access to their phones and computers and use information gleaned from those devices.

“This isn’t something that’s unique to prosecutions related to self-managed abortion,” Diaz-Tello said. “This sort of law enforcement intrusion into people’s private data has been relatively commonplace.”